The Sibling Relationship in the Context of Child Maltreatment: What Do We Know? What Are the Directions for the Future?

Violence as a Health Problem

Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual's life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social. A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care. Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities. In summary, this work aims to promote the training and awareness of all professionals specialized in children's health, so that they pursue the goal of achieving their patients' greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice.

Noticing the unutilized resource of siblinghood: Key conclusions from a scoping review about siblings in out-of-home placements

BACKGROUND

Sibling bonds are often the most enduring relationship in an individual's life span. The out-of-home placement of siblings is widespread and may significantly influence children's journeys and wellbeing.

OBJECTIVE

The current scoping literature review was designed to characterize and analyze the existing knowledge regarding siblings in out-of-home placements.

METHOD

Key databases were explored using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, which identified 33 studies relevant to the current study's focus. The studies used quantitative, qualitative, and mixed methods and included a variety of out-of-home placement settings and sample characteristics.

RESULTS

Utilizing thematic analysis, the findings addressed three main themes: the sibling bond as a contributor to the wellbeing of children in out-of-home placements, trends in sibling placement, and difficulties in maintaining the sibling bond in out-of-home placements regarding micro, meso and exo factors.

CONCLUSION

A key conclusion from the review is that the welfare system struggles to address a child as a part of a sibling group and an extensive and multilayered relational network; hence, siblinghood is an unutilized resource in out-of-home placements. Future directions for practice, policy and research are included and discussed.

Domestic Abuse Sibling studY (DASY): a multimethod study protocol

INTRODUCTION

Domestic violence and abuse (DVA) is an everyday aspect of many children and young people's lives, both in the home and in their own relationships. Studies estimate that up to one million children and young people experience some form of DVA each year in the UK. Although the majority of families experiencing DVA have more than one child, most research to date has focused on individual children within these families. This study aims to explore the views of practitioners, parent/carers and young people on sibling responses in the context and aftermath of DVA. Our protocol has followed SPIRIT guidelines.

METHODS AND ANALYSIS

We propose a multimethod study consisting of semistructured interviews, the completion of Sibling Relationship Questionnaires, photovoice interviews and illustrative case studies to explore sibling experiences in the context and aftermath of DVA. A purposive sample of front-line practitioner participants will be recruited and interviewed first. We will ask them to introduce us to parent/carer and young people participants using a snowball approach (n=70). Qualitative data will be analysed through reflexive thematic analysis, theoretically underpinned by critical realism, to explore patterns in participants' views and experiences of siblings in the context and aftermath of DVA. Quantitative data collected from the Sibling Relationship Questionnaire's four domains (warmth/closeness, power/status, conflict and rivalry) will be analysed. Data triangulation of the quantitative and qualitative data within this study will occur at the results interpretation stage.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the University of Birmingham Research Ethic Committee (ERN_21-0795). Findings will be published in open access peer-reviewed journals and presented at relevant conferences and events. Child-facing infographics and front-line practitioner guides will also be produced.

Siblings' Perspectives of the Impact of Child Sexual Abuse Disclosure on Sibling and Family Relationships

Child sexual abuse (CSA) may have significant consequences for siblings; however, limited research has been conducted on the impact of the abuse on sibling and family relationships following the disclosure of CSA. This study sought to investigate sibling responses to disclosures of CSA among a group of adult siblings in Ireland, and the impact on sibling and family relationships through an online survey. A thematic analysis was conducted on a sub-set of participants who responded to open-ended questions (n = 45). Three main themes were identified as follows: (a) intense emotional reactions, (b) relationship support and strain, and (c) managing family dynamics. CSA disclosure may have a substantial impact on sibling and family relationships. Supporting siblings in the aftermath of CSA disclosure is essential, both for the well-being of the individual who was sexually abused and for the wider family.

Unspoken: Child-Perpetrator Dynamic in the Context of Intrafamilial Child Sexual Abuse

The literature on child sexual abuse (CSA) has contributed greatly to the understanding of child-perpetrator dynamic while mainly addressing the concepts of grooming and manipulation. Considerably less attention has been dedicated, however, to child-perpetrator dynamic in intrafamilial child sexual abuse (IFCSA). The current study examined how children perceive and experience the dynamic with their perpetrator parents in the context of IFCSA, as conveyed by victims. Analysis of 29 forensic interviews with children aged 8 to 14 years suggested above all, across all identified themes, the unspoken nature of IFCSA. Specifically, the children shared their surprise at the abusive incidents despite having described a long and unspoken grooming process. The children shared their understanding of the secretive nature of IFCSA although that too was unspoken, while illustrating the fear and terror in the family dynamic. Finally, the children discussed the elusiveness of the dynamic in terms of the natural and unnatural aspects of the relationship. The discussion addresses the unique nature of IFCSA and the family dynamic. The main implication for practice is the urgent need to modify existing instruction and training programs for practitioners to better adjust them to IFCSA survivors. More specifically, the elusive nature of IFCSA must be conveyed to both clinical and forensic practitioners who need to evaluate and intervene in with child survivors of IFCSA. In addition, the fear and terror that characterize the family dynamic and the unspoken, unbridled rule of the perpetrator fathers are of central importance in adapting interventions to children and their families in the context of IFCSA.

Prevalence and Contributing Factors of Childhood Trauma, Anxiety, and Depression Among Adolescents From Two-Child Families in China

The two-child policy has been implemented in China since 2016 and has attracted the attention of the world. Adolescents may face huge psychological challenges in the process of changing family structures and relationships. To date, no mental health survey of adolescents from two-child families has been conducted. We investigated the prevalence and risk factors for childhood trauma, anxiety, and depression in two-child families in a statistically representative sample of Chinese senior high school students from Shanghai. A total of 426 participants were randomly selected from 1,059 students of four senior high schools in different districts of Shanghai. The childhood trauma questionnaire-short form (CTQ-SF), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used as the screening tools. We found that the overall prevalence of childhood trauma, anxiety, and depression among senior high school students in two-child families was 46.70% (95% CI, 39.93-53.47%), 22.17% (95% CI, 16.53-27.81%), and 35.85% (95% CI, 29.34-42.36%), respectively. The two-child families was an important factor associated childhood trauma, emotional neglect, and physical neglect (χ² = 5.984, p = 0.014; χ² = 4.071, p = 0.044; χ² = 4.202, p = 0.040). Ranking in two-child families was a risk factor for childhood trauma (β = -0.135, p = 0.048). Parental preference was a significantly correlated with physical abuse, physical neglect, anxiety, and depression (β = -1.581 to 0.088, p < 0.05). Meanwhile, emotional abuse, physical abuse, emotional neglect, and physical neglect of participants in the two groups were positively correlated with anxiety and depression (r = 0.195-0.478, p < 0.05). There was a significant relationship between sexual abuse and anxiety symptoms in the one-child family group (r = 0.161, p < 0.05). The findings suggest that the overall prevalence of childhood trauma, anxiety and depression among adolescents from two-child families in China was high. The two-child families and family ranking are important factors associated childhood trauma, while parental preference is related to anxiety and depression. These results highlight an urgent need to be addressed by adolescents' mental health service providers and policy-makers.

Multimorbidity and polyvictimization in children - An analysis on the association of children's disabilities and long-term illnesses with mental violence and physical violence

BACKGROUND

Children's disabilities and long-term illnesses (DLTIs) are a significant risk factor in the development of maltreatment.

OBJECTIVE

The study is focused on the association of children's DLTIs with child maltreatment and poly-victimization perpetrated by parents.

PARTICIPANTS AND SETTING

The study is based on a 2013 Child Victim Survey (N = 11,364), which is a cross-sectional survey. This nationally representative survey focused on the life situation of Finnish children aged 12-17 years, as well as on experiences of violence, crime, and bullying.

METHODS

Multinomial logistic regression analysis was used to examine the association of children's DLTIs and child maltreatment.

RESULTS

Poly-victimization played a significant role in child maltreatment. Children's hearing impairment (OR 5.68, 95% Cl 2.25-14.35), physical disability (OR 3.32, 95% Cl 1.61-6.88), and mental health problems (OR 4.37, 95% Cl 1.63-11.72) increased the odds of poly-victimization more than other forms of abuse. The situation was similar with both somatic diseases (OR 1.59, 95% Cl 1.14-2.21) and psychiatric illnesses (OR 2.12, 95% Cl 1.36-2.47) in children. Further, somatic and psychiatric multimorbidity in children increased the odds of poly-victimization (OR 4.17, 95% Cl 2.25-7.75) slightly more than risk of physical abuse (OR 3.57, 95% 1.11-11.49). As control variables, child's gender and age, the family financial situation, and the parent's intimate partner violence were adjusted in all of the analyses.

CONCLUSION

Clinical professionals should consider children's multimorbidity as a potential risk factor of maltreatment. The results of the study can be used to support families and children with DLTIs.

"It burns her more than it burns for me": The sibling subsystem in the context of child physical abuse as portrayed by children during forensic interviews

BACKGROUND

The sibling subsystem is a central and potentially protective factor for children. Nevertheless, in the context of child abuse, it remains surprisingly understudied.

OBJECTIVE

The current study was designed to examine how children referred to a forensic interview following suspected physical abuse experienced and perceived the sibling subsystem.

PARTICIPANTS AND SETTING

The sample included 60 forensic interviews with children, aged 4 to 14. Each child had at least one sibling and referred to this sibling in the context of the abuse they experienced.

METHODS

Thematic analysis was carried out on the narratives provided by the children. Several steps were taken to ensure the trustworthiness of the study, with four criteria: credibility, transferability, dependability, and confirmability.

RESULTS

The main theme identified was physical abuse as a familial routine. This abusive routine was sometimes perceived as normal and sometimes traumatic, with descriptions of fear and physical pain. The children addressed the various figures in this abusive routine. When these horrific daily experiences were elaborated on, the children often captured the sibling subsystem as a source of security, comfort and protection. Moreover, the children's language often communicated the siblings' bond, referring to "we" and "us." Within a few narratives, a split between the siblings was identified, which appeared to be a strategy of self-protection by going against their siblings.

CONCLUSION

The current findings join the recent accumulating evidence with respect to the centrality of the sibling subsystem in the experiences and consequences of child abuse. It is imperative to advance practitioners' knowledge and interventions to better adapt to the central role of the sibling subsystem in the context of child abuse.

A systematic review and meta-analysis of the associations between interparental and sibling relationships: Positive or negative?

According to family systems theory, a family is regarded as an organized whole and relations within this system are interconnected. However, it is not clear to date whether the interparental and the sibling relationship are associated and, if such an association exists, whether it is positive or negative. Previous findings on the associations between the interparental and sibling relationships are inconsistent and there is as yet no pertinent review or meta-analysis. Therefore, this systematic review and meta-analysis set out (1) to aggregate previous studies investigating the links between the interparental and sibling relationships and (2) to examine potential moderators in this link. Based on 47 studies reporting 234 effect sizes (N = 29,746 from six nations; 6-12 years; 49% boys), meta-analytic results suggest a small positive correlation between interparental and sibling relationship quality (r = .14). Only the percentage of male children in the sample moderated this effect. Sex composition of sibling dyad and source of publication affected whether positive or negative associations were found. The findings support a growing consensus that family relations do not function in isolation, but are mutually interdependent, which should be considered in clinical practice.

The Role of Kinship and Siblings in Young Children's Placement Preferences

Although considerable attention has been directed toward the most appropriate placement for children following removal from home due to maltreatment, very little of this attention has focused on children's stated preferences, particularly when children are young. Specifically, children below 12 years of age are often presumed incompetent to form reasoned judgments about their best interests in placement. This assumption, however, has rarely been tested directly. We surveyed 100 4- to 11-year-olds removed from home because of maltreatment about their placement preferences. Children were less likely to indicate they wanted to return home if they were placed with siblings or with kin, consistent with statutory placement preferences. These results suggest that young children may express more mature preferences than recognized by the law, and that there may be value in asking even relatively young children about with whom they would like to live following their removal from home as a result of maltreatment.

Sibling Relationships of Adolescents with Congenital Heart Disease

Adolescents with congenital heart disease (CHD) continuously need family support because of their repeated follow ups, treatments, and complications. However, sibling relationships have not been well studied among adolescents with CHD. The purpose of the present study was to explore the relationships between adolescents with CHD and their siblings, and to examine these relationships according to birth order and age. Adolescents aged from 13 to 21 years who had been diagnosed with CHD and had siblings were included as participants. The Sibling Relationship Questionnaire (SRQ) was used. The SRQ consists of four factors: warmth/closeness, conflict, relative power/status, and rivalry. A univariate general linear model was conducted to identify the sibling relationship factors according to birth order and sibling ages. The score for relative power/status of participants who were the eldest sibling was higher than that of younger siblings. The score for rivalry increased as sibling age increased. Therefore, healthcare providers need to investigate sibling relationships and to explain the importance of self-identity and power balance between adolescents with CHD and their siblings to parents.

My Brother's Keeper? The Sibling Subsystem in the Context of Physical and Sexual Child Abuse

The sibling subsystem is of central importance and a possible protective factor for children. Nevertheless, it remains surprisingly understudied and lacks any theoretical or conceptual framework. The current study explored the sibling subsystem in the context of child abuse (CA). Thorough thematic analysis was conducted on the narratives of 30 children referred to forensic interviews following suspected physical or sexual abuse by a parent. Aged 4-14, all had at least one sibling each and referred to this sibling during their interviews in the specific context of the CA they had experienced. Their narratives shed light on two dynamics that can characterize the sibling subsystem in the context of CA: compensation and spillover of the trauma into the sibling subsystem. They stress the centrality of the sibling subsystem in the children's lives and the siblings' role in the children's survival of CA. The current study's findings emphasize the urgency of continuing to develop studies in this area, as they will likely contribute to both prevention and intervention efforts.

Aggression in Children Exposed to Intimate Partner Violence: A Comparison of Maternal, Sibling, and Observer Perspectives

The negative effects of exposure to intimate partner violence (IPV) on children have been well documented, including externalizing difficulties such as aggression. Although aggressive behavior is a common concern for these children, sibling aggression in children exposed to IPV has rarely been studied. Our purpose was to investigate similarities and differences in multiple informant reports of aggression by siblings exposed to IPV, and to examine how exposure to IPV was linked to these differing perspectives. Forty-seven sibling dyads and their mothers were recruited from the community. Aggression was assessed by observers, by mothers, and by the siblings themselves, whereas IPV was assessed by both maternal and child report. Informants had very differing views on aggression. Regression results indicated that children's reports of their own exposure to IPV accounted for significant variance in observed aggression between siblings, as well as in the maternal reports of aggression by both siblings. Aggression did not vary by sibling age, sex, or age spacing. Results were discussed within a risk and resilience framework.

Quality of Sibling Relationships in Maltreated Youth Residing in Out-of-Home-Care

When children are removed from their parents's custody because of substantiated maltreatment and placed in out-of-home placements, they may be placed separately from siblings, potentially leading to even higher levels of stress in children. This possibility emerges insofar as siblings serve as a source of support during the uncertain times that accompany maltreatment and subsequent removal. We explored these issues in the present study, focusing on whether sibling relationship quality was related to post-removal behavioral functioning in maltreated children and adolescents. A total of 102 six- to seventeen-year-olds residing in a residential facility completed questionnaires about their sibling relationship quality and behavioral functioning. With age, sibling relationships became more hostile; although in girls, sibling affection also increased with age, at least when their sibling was a girl. Sibling hostility was related to increases in aggression and behavioral problems. Surprisingly, greater sibling affection was associated with increased problems, particularly when children had little contact with their sibling. Results provide insight into perceptions of sibling relationships in maltreated children and have implications for placement decisions.